Functional outcomes attained by T9-12 paraplegic patients with the walkabout and the isocentric reciprocal gait orthoses.

Abstract

To compare the functional outcomes attained by persons with paraplegia using the Walkabout Orthosis (WO) and the Isocentric Reciprocal Gait Orthosis (IRGO). A randomized crossover design. Ten subjects with complete lesions between T9-T12. Over two 8-week periods, subjects were taught to use each orthosis in conjunction with elbow crutches. After each 8-week training period, subjects were assessed on their ability to perform five different sets of key skills associated with functional ambulation. There were no differences between orthoses in the ability of subjects to don and doff the orthoses, get up and down stairs and curbs, or walk on a flat surface. Subjects required significantly more assistance when using the WO to walk over inclined surfaces (median IRGO = "independent," median WO = "minimal assistance"; p = .03) but less assistance when using the WO to get from sitting to standing and standing to sitting (median IRGO = "moderate assistance," median WO = "minimal assistance"; p = .03). In addition, subjects walked significantly faster with the IRGO both on the flat (mean IRGO = .34 m/sec +/- .18, mean WO = .14 m/sec +/- .12; p = .002) and on inclined surfaces. Although it is easier to stand up and sit down with the WO, the IRGO facilitated a faster and more independent gait. Neither orthosis enabled subjects to be fully independent in the key skills necessary for functional ambulation after 8 weeks of training.